Over the last three decades, a great deal of progress has been made regarding the genetics, natural history, diagnosis, accurate staging and therapeutic modalities of rectal cancer. This development has led to a substantial improvement in survival and local recurrence rates, exceeding those achieved for colon cancer. Even though surgery remains the cornerstone of the treatment of rectal cancer, research has continued to establish new guidelines for a multi-modality treatment resulting in even further improved recurrence and survival rates, and quality of life.This publication features reviews on current knowledge and treatment trends, ranging from neo-adjuvant chemoradiation and radiotherapy to preoperative staging and the advantages and challenges of a laparoscopic approach. Moreover, in a review of the molecular biological changes characterizing colorectal cancer, the possible implementations of genetic studies in screening and follow-up are discussed. Finally, the issue also includes original articles focusing on various aspects of the management of patients suffering from the disease.